According to official media, at least 116 people were killed when buildings in northwest China collapsed due to an earthquake.
Local officials said that at least 105 people were killed and almost 400 were injured in Gansu province when the strong, shallow tremor struck about midnight.
According to CCTV, 11 people were murdered and 100 were injured in the city of Haidong in the nearby province of Qinghai.
According to state news agency Xinhua, the earthquake destroyed homes and caused major damage, prompting people to flee the street for safety.
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"I was almost scared to death. Look at how my hands and legs are shaking," said a woman of about 30 in a video posted to a social media account associated with the state-run People's Daily newspaper.
"As soon as I ran out of the house, the earth on the mountain gave way, thudding on the roof," she recounted, clutching a baby in a blanket outdoors.
CCTV footage showed household belongings among dispersed masonry from a house caved in during the earthquake.
Early Tuesday, rescue attempts were underway, with Chinese President Xi Jinping calling for "all-out efforts" in the search and relief mission.
Temperatures in the high-altitude location are below freezing, and rescuers should be on the lookout for secondary disasters, he warned, according to CCTV.
The US Geological Survey reported a magnitude 5.9 earthquake in Gansu, near the border with Qinghai, where Haidong is located.
This epicenter is about 100 kilometers (60 miles) southwest of Lanzhou, the capital of Gansu province.
The quake's magnitude, which was felt in the important city of Xi'an in northern Shaanxi province, roughly 570 kilometres (350 miles) distant, was estimated by Xinhua to be 6.2.
Following the original earthquake, there were several lesser aftershocks, and officials cautioned that earthquakes with magnitudes greater than 5.0 were possible in the coming days.
On Monday morning, the USGS reported a magnitude 5.2 earthquake further northwest in Xinjiang province.
